: This case presentation describes a 47-year-old woman who developed complex regional pain syndrome type II with severe neuropathic pain following iatrogenic transection of the tibial nerve at the ankle. The pain and disability progressively worsened over time, markedly impaired ambulation, and were not relieved despite various analgesic treatments. After injection of botulinum toxin (abobotulinumtoxinA, BoNT-A) in the leg muscles the tendons of which pass through the tarsal tunnel (together with the tibial nerve), her pain decreased and her walking capacity improved...

Cervical dystonia is the most common form of dystonia in adult age. It is characterized by involuntary muscle contractions that cause abnormal movements and positioning of the head and neck. Symptoms of it are often associated with pain. This distinguishes this form from other dystonia. The drug of choice is botulinum toxin. It effectively reduces both pain and abnormal excessive muscle activity. In some cases, particularly where there is not obtained the full recovery after treatment botulinum toxin we used drugs for systemic effect...

Cervical dystonia is the most common form of dystonia in adult age. It is characterized by involuntary muscle contractions that cause abnormal movements and positioning of the head and neck. Symptoms of it are often associated with pain. This distinguishes this form from other dystonia. The drug of choice is botulinum toxin. It effectively reduces both pain and abnormal excessive muscle activity. In some cases, particularly where there is not obtained the full recovery after treatment botulinum toxin we used drugs for systemic effect...

PURPOSE OF REVIEW: This article addresses nocebo in headache. Nocebo is the antipode of placebo and refers to adverse events a person manifests after receiving placebo. RECENT FINDINGS: In randomized trials for migraine prevention meta-analyses revealed that eight out of 20 patients treated with placebo experienced any adverse event. More importantly, one out of 20 patients treated with placebo withdrew treatment because of adverse events. The adverse events in placebo groups mirrored the adverse events expected of the active medication studied, confirming that pretrial suggestions induce the adverse events in placebo-treated patients...

Achalasia is a motility disorder of the esophagus characterized by dysphagia, regurgitation of undigested food, chest pain, weight loss and respiratory symptoms. The most common form of achalasia is the idiopathic one. Diagnosis largely relies upon endoscopy, barium swallow study, and high resolution esophageal manometry (HRM). Barium swallow and manometry after treatment are also good predictors of success of treatment as it is the residue symptomatology. Short term improvement in the symptomatology of achalasia can be achieved with medical therapy with calcium channel blockers or endoscopic botulin toxin injection...

The study analyses results of treatment of 196 patients, with cerebral palsy, which underwent a course of health-resort treatment is performed. Past medical history of patients for the last 10 years was also analysed. It was found that the use of botulin toxin <A> (BT-A) <Dysport®> as a part of complex rehabilitation of the patients significantly improved the effectiveness of the treatment. It was determined that the reasons of the lack of spasticity reduce are caused by degeneration of the muscles...

OBJECTIVE: The association of bilateral hypertrophy of temporalis and masseteric muscles is a rare clinical entity. The origin of the condition is unclear, causing cosmetic problems, pain, and functional impairment. PATIENTS AND METHODS: In this paper we analyzed 15 patients treated at the Department of Maxillo-Facial Surgery of the University of Naples Federico II, from 2000 to 2013, for temporalis and/or masseteric muscle hypertrophy, and in particular, a rare case of a patient with a marked bilateral swelling of the temporalis and masseteric region, in conjunction with a review of the literature...

BACKGROUND: The coexistence of hemifacial spasm and trigeminal neuralgia, a clinical entity known as painful tic convulsive, was first described in 1910. It is an uncommon condition that is worthy of interest in neurosurgical practice, because of its common pathophysiology mechanism: Neuro-vascular compression in most of the cases. OBJECTIVE: To present 2 cases of painful tic convulsive that received treatment at our institution, and to give a brief review of the existing literature related to this...

INTRODUCTION: Foodborne botulism is a neuroparalytic disease caused by ingestion of food contaminated with botulinum toxins. Despite rare the mortality rate is high if untreated. Diagnosis of botulism is still a challenge for clinician, due to the variability of clinical manifestations and disease course. We report on a child with type B botulin intoxication who was early diagnosed and treated underlining that clinical suspicion is crucial to start prompt treatment. CASE PRESENTATION: An 11-year-old boy presented with bilateral ptosis and mydriasis, dry mouth, difficulty in swallowing, dysphonia, urine retention and constipation...

The muscular anatomy of the face is complex. Animation patterns of facial muscles vary significantly among individuals. Activity of facial muscles determines expression and emotion and affects the eyes aperture and the amount and extent of facial rhytids. Injection of botulin toxin for facial rejuvenation has become a very popular procedure and allows the practitioner the ability to modulate facial expression and to decrease the amount of facial rhytids. A thorough knowledge of the variant facial anatomy is necessary to maximize the efficiency of botulin toxin injection...

Probiotics are live microorganisms ingested for the purpose of conferring a health benefit on the host. Development of new probiotics includes the need for safety evaluations that should consider factors such as pathogenicity, infectivity, virulence factors, toxicity, and metabolic activity. Clostridium butyricum MIYAIRI 588(®) (CBM 588(®)), an anaerobic spore-forming bacterium, has been developed as a probiotic for use by humans and food animals. Safety studies of this probiotic strain have been conducted and include assessment of antimicrobial sensitivity, documentation of the lack of Clostridium toxin genes, and evaluation of CBM 588(®) on reproductive and developmental toxicity in a rodent model...

Although interventional procedures should be used cautiously in the setting of chronic pain, there is a role for a variety of injections to facilitate a patient's overall rehabilitation program. There are many resources available, including a prior issue of Physical Medicine and Rehabilitation Clinics of North America, which discuss the more conventional spinal injections. The focus of this article is on lesser-known injection options for treating chronic pain. The authors separately discuss trigger point injections, regenerative injections (prolotherapy), and injections using botulin toxins...

Spasticity is a motor disorder with an increased muscle tone, typically associated with spasms, weakness and lack of coordination. It is an invalidating and debilitating pathology, characterized by pain, limited autonomy in activities of daily living, development of severe lesions. Spasticity can be adequately treated with physiotherapy, muscle relaxants drugs or topical treatment with botulinic toxin type A. Intrathecal baclofen therapy is very effective in the treatment of severe and generalized spasticity...

OBJECTIVE: A significant fraction of patients with amyotrophic lateral sclerosis (ALS) are unable to swallow saliva, which may result in the spillage of saliva outside of the oral cavity. Although anticholinergic agents and botulin toxin injections are considered the first line of treatment, they have not been effective for all patients. We performed a literature search on therapeutic salivary gland irradiation in patients with ALS. METHODS: We searched the PubMed for English language publications up to December 2014 on therapeutic salivary gland irradiation in patients with ALS...

INTRODUCTION: Juvenile Cerebral Palsy--is caused by damage of the motor control centers of the developing brain (cerebral refers to the cerebrum, which is the affected area of the brain, although the disorder probably involves connections between the cortex and other parts of the brain and palsy refers to disorder of movement). The clinical symptoms of juvenile cerebral palsy are very diversified and include gross and fine motor-coordination disorders, manual ability, locomotion, perception and response, speech, psychomotor retardation, emotional disorders...

Comparative estimation of results for endoscopic lifting of the face upper part in dynamics of early and late postoperative period was adduced. In accordance to results of analysis, concerning the eyebrows height in a control terms, there was established, that through one year postoperatively the eyebrows have a tendency towards ptosis due to activity of the eyes circular muscles. Deterioration of the result achieved post-operatively is less prominent in patients after preliminary chemical denervation of mimic muscles...

BACKGROUND: Hyperhidrosis is a condition characterized by generalized or localized hyperfunction of the eccrine sweat glands with a deep negative impact on patient's quality of life. OBJECTIVES: To evaluate the efficacy and the safety of Botulin Toxin A (BTX-A) intradermal injection in the treatment of primary axillary and palmar hyperhidrosis, investigating symptoms-free period, and the subjective improving of quality life. MATERIALS AND METHODS: 50 consecutive patients with primary hyperhidrosis were evaluated detecting age, gender, hyperhidrosis onset period, disease duration and years of treatment with BTX-A, Minor's iodine test, Hyperhidrosis Disease Severity Scale (HDSS), Dermatology Life Quality Index (DLQI)...

Acute recurrent pancreatitis (ARP) refers to a clinical entity characterized by episodes of acute pancreatitis which occurs on more than one occasion. Recurrence of pancreatitis generally occurs in a setting of normal morpho-functional gland, however, an established chronic disease may be found either on the occasion of the first episode of pancreatitis or during the follow-up. The aetiology of ARP can be identified in the majority of patients. Most common causes include common bile duct stones or sludge and bile crystals; sphincter of oddi dysfunction; anatomical ductal variants interfering with pancreatic juice outflow; obstruction of the main pancreatic duct or pancreatico-biliary junction; genetic mutations; alcohol consumption...